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Pharmacologic Management of Perioperative Pulmonary Hypertension

Cheng, Julie W. MAE*; Tonelli, Adriano R. MD; Pettersson, Gosta MD, PhD; Krasuski, Richard A. MD, FACC§

Journal of Cardiovascular Pharmacology: April 2014 - Volume 63 - Issue 4 - p 375–384
doi: 10.1097/FJC.0000000000000050
Review Article

Abstract: Perioperative pulmonary hypertension can originate from an established disease or acutely develop within the surgical setting. Patients with increased pulmonary vascular resistance are consequently at greater risk for complications. Despite the various specific therapies available, the ideal therapeutic approach in this patient population is not currently clear. This article describes the basic principles of perioperative pulmonary hypertension and reviews the different classes of agents used to promote pulmonary vasodilation in the surgical setting.

*Case Western Reserve University School of Medicine, Cleveland, OH;

Departments of Pulmonary, Allergy, and Critical Care Medicine; and

Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH; and

§Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.

Reprints: Richard A. Krasuski, MD, FACC, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue/Mail Code J2-4, Cleveland, OH 44195 (e-mail:

A.R.T. is supported by the CTSA KL2 Grant # RR024990, from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. R.A.K. is a consultant and on the speaker's bureau of Actelion Pharmaceuticals and on the scientific advisory board for Ventripoint.

The authors report no conflicts of interest.

Received August 02, 2013

Accepted November 13, 2013

© 2014 by Lippincott Williams & Wilkins.